靜脈注射乙醇導致急性中毒之病例報告

20歲健康男性軍人，自購高濃度乙醇注射中毒(ethanol intoxication)，導致昏迷、雙眼視力嚴重減退，且未接受任何治療，至第六日才被送至本院急診室，於眼科理學檢查發現右眼前10cm可辨指數，左眼15cm可辨指數皆與無法矯正，視野檢查呈現兩眼明顯集中壓縮型視野缺損(concentrically constricted visual field defect)，眼底檢查發現兩眼視凹陷擴大、視凹陷、視盤比例右眼0.7×0.6左眼0.7×0.6顳側視神經萎縮(temporal side optic nerve atrophy)、視神經盤充血(disc hyperemia)、右眼視神經盤旁9及11點鐘方向出現裂片狀出血(splinter hemorrhage)，左眼視網膜呈現一綿絮狀斑(cotton wool spot)，眼底螢光血管攝影檢查發現視網膜血管阻塞破裂出血所造成的阻隔顯影(blocked fluorescence)及低螢光劑染色(hypoflurescence staining)。神經學檢查並無特別異常，血液檢查方面：血液常規顯示出輕度貧血(HGB: 7.0g/dL，HCT: 22.1%)及白血球下降(WBC: 3500/ul)、生化、動脈血氣體分析(ABG)皆正常，核磁共振造影(MRI)顯示出兩眼球球後出血（T1 weighted fat suppression 下）、兩側視丘(thalamus )點狀出血，予以住院接受支持性治療及進一步診療。

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並列摘要

We presented a case of high dose intravenous ethanol injection induced acute intoxication. Patient was a healthy young male who attempted to suicide with intravenous injection of ethanol about 200m1 then the symptom of marked visual loss(HM/10cm OD, HM/15cm OS) was noted after 6 days. He was diagnosed by serum gas chromatography of ethanol (5mg/dL after 14 days of injection); ocular pictures of intoxication (disc splinter hemorrhage; retinal cotton wool spot; retrobulbar hemorrhage); spotting hemorrhage of bilateral thalamus and mild anemia. After supported treatment with Vitamin B1 and B6 for 1 month. Visual acuity improved to 6/30 OD, 6/6.7 OS. Since the prognosis is satisfied for ocular enthanol intoxication, early diagnosis is important to find out the ocular picture. The very rare case of injected ethnol intoxication was never reported before. The clinical course, and neuropathological characteristics were presented here.

並列關鍵字

ethanol intoxication ； optic nerve atrophy ； retrobulbar hemorrhage ； splinter hemorrhage

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靜脈注射乙醇導致急性中毒之病例報告

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